The role of mean platelet volume, platelet distribution width and platelet / lymphocyte ratio in development of cerebral venous thrombosis
Öz
Objective:
Mean platelet volume (MPV) and platelet distribution width (PDW) are parameters
that indicate platelet volume. It is assumed that large platelets are
enzymatically and metabolically more active than small platelets. The
relationship between elevated MPV and PDW values and arterial thrombosis has
been demonstrated, but their roles in venous thrombosis are not fully
understood. While the platelet / lymphocyte ratio (PLR), which is considered to
be an inflammatory indicator, is known to be associated with many diseases,
there are only a few studies in venous thrombosis. For this reason, our aim in
this study is to establish the relationship between MPV, PDW and PLR values and
cerebral venous sinus thrombosis (CVST).
Method:
Our study included 54 patients who were diagnosed with CVST in our clinic
between January 2008 and September 2016, and 50 controls with similar age and
sex. The patients and control groups were compared in terms of MPV, PDW and PLR
values. In addition, the patient group was divided into two groups, according
to parenchymal brain lesions, and the effect of MPV, PDW, and PLR on prognosis
was also assessed.
Results:
While the MPV, PDW and PLR values were higher in the patient group compared to
the controls, there was no significant difference between patients with and
without parenchymal lesions. In addition, as MPV and PDW values for CVST
development were determined as significant independent variables, optimal
cut-off values were identified 8.85 for MPV, 15.75 for PDW and 168.53 for PLR
in ROC analysis.
Conclusions:
As a result, MPV, PDW and PLR values were higher in patients with SVST than
controls, however their prognostic significance was not determined. In
addition, we may suggest that higher MPV and PDW values are new independent risk
factors for CVST development.
Anahtar Kelimeler
Mean platelet volüme platelet distribution width platelet / lymphocyte ratio cerebral venous thrombosis
Kaynakça
- 1. Masuhr F, Mehraein S, Einhaupl K. Cerebral venous and sinus thrombosis. J Neurol. 2004; 251: 11-23.
- 2. Zubkov AY, McBane RD, Brown RD, Rabinstein AA. Brain lesions in cerebral venous sinus thrombosis. Stroke. 2009; 40: 1509-11.
- 3. Lo´pez JA, Chen J. Pathophysiology of venous thrombosis. Thromb Res 2009;123(suppl 4):S30-S34.
- 4. Kuroiwa Y, Yamashita A, Miyati T, et al. MR signal change in venous thrombus relates organizing process and thrombolytic response in rabbit. Magn Reson Imaging 2011; 29: 975-84.
- 5. Puddu P, Muscari A, Puddu GM, Cravero E, Giannoni C, Zoli M. The complexity of platelet metabolism and its contribution to atherothrombosis. Acta Cardiol 2009; 64: 157-65.
- 6. Mayda-Domac¸ F, Misirli H, Yilmaz M. Prognostic role of mean platelet volume and platelet count in ischemic and hemorrhagic stroke. J Stroke Cerebrovasc Dis 2010; 19: 66-72.
- 7. Vizioli L, Muscari S, Muscari A. The relationship of mean platelet volume with the risk and prognosis of cardiovascular diseases. Int J Clin Pract 2009; 63: 1509-15.
- 8. Demirtunc R, Duman D, Basar M, Bilgi M, Teomete M, Garip T. The relationship between glycemic control and platelet activity in type 2 diabetes mellitus. J Diabetes Complications 2009; 23: 89-94.
- 9. Zuberi BF, Akhtar N, Afsar S. Comparison of mean platelet volume in patients with diabetes mellitus, impaired fasting glucose and nondiabetic subjects Singapore Med J 2008; 49: 114-6.
- 10. Jindal S, Gupta S, Gupta R, et al. Platelet indices in diabetes mellitus: indicators of diabetic microvascular complications. Hematology 2011; 16: 86-9.
- 11. De Luca G, Venegoni L, Iorio S, et al. Platelet distribution width and the extent of coronary artery disease: results from a large prospective study. Platelets 2010; 21: 508-14.
- 12. Kamisli O, Kamisli S, Kablan Y, et al. The Prognostic Value of an Increased Mean Platelet Volume and Platelet Distribution Width in the Early Phase of Cerebral Venous Sinus Thrombosis. Clinical and Applied Thrombosis/Hemostasis 2013; 19: 29-32.
- 13. Ntaios G, Gurer O, Faouzi M, Aubert C, Michel P. Hypertension is an indepedent predictor of mean platelet volume in patients with acute ischemic stroke [published online January 4, 2010]. Intern Med J 2010.
- 14. Chu SG, Becker RC, Berger PB, et al. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and metaanalysis. J Thromb Haemost. 2010; 8: 148-56.
- 15. Vagdatli E, Gounari E, Lazaridou E, Katsibourlia E, Tsikopoulou F, Labrianou I. Platelet distribution width: a simple, practical and specific marker of activation of coagulation. Hippokratia 2010; 14: 28-32.
- 16. Braekkan SK, Mathiesen EB, Njølstad I, Wilsgaard T, Størmer J, Hansen JB. Mean platelet volume is a risk factor for venous thromboembolism: the Tromsø Study, Tromsø, Norway. J Thromb Haemost 2010; 8: 157-62.
- 17. Gulcan M, Varol E, Etli M, Aksoy F, Kayan M. Mean platelet volume is increased in patients with deep vein thrombosis [published online November 22, 2011]. Clin Appl Thromb Hemost. 2011.
- 18. Cay N, Ipek A, Gumus M, Birkan Z, Ozmen E. Platelet activity indices in patients with deep vein thrombosis [published online September 23, 2011]. Clin Appl Thromb Hemost. 2011.
- 19. Simanek R, Vormittag R, Ay C, et al. High platelet count associated with venous thromboembolism in cancer patients: results from the Vienna Cancer and Thrombosis Study (CATS). J Thromb Haemost 2010; 8: 114-20.
- 20. Ishihara H, Kondo T, Yoshida K, et al. Effect of Systemic Inflammation on Survival in Patients With Metastatic Renal Cell Carcinoma Receiving Second-line Molecular-targeted Therapy. Clin Genitourin Cancer 2017 Feb 1. pii: S1558-7673(17)30034-4. doi:10.1016/j.clgc.2017.01.018. [Epub ahead of print]
- 21. Bin He C, Lin X.J. Inflammation scores predict the survival of patients with hepatocellular carcinoma who were treated with transarterial chemoembolization and recombinant human type-5 adenovirus H101. PLoS One 2017; 12: e0174769.
- 22. Liu H, Wu Y, Wang Z, Yao Y, Chen F, Zhang H, et al.. Pretreatment platelet-to-lymphocyte ratio (PLR) as a predictor of response to first-line platinum-based chemotherapy and prognosis for patients with non-small cell lung cancer. J Thorac Dis 2013; 5: 783-9.
- 23. Yang W, Liu Y. Platelet-lymphocyte ratio is a predictor of venous thromboembolism in cancer patients. Thromb Res 2015; 136: 212-5.
- 24. Ly HQ, Kirtane AJ, Murphy SA et al: Association of platelet counts on pre¬sentation and clinical outcomes in ST-elevation myocardial infarction (from the TIMI Trials). Am J Cardiol 2006; 98: 1-5.
- 25. Osadnik T, Wasilewski J, Lekston A, et al. The platelet-to-lymphocyte ratio as a predictor of all-cause mortality in patients with coronary artery disease undergoing elective percutaneous coronary intervention and stent implantation. J Saudi Heart Assoc 2015; 27: 144-51.
- 26. Gary T, Pichler M, Belaj K et al: Platelet-to-lymphocyte ratio: a novel marker for critical limb ischemia in peripheral arterial occlusive disease patients. PLoS One 2013; 8: 676-88.
- 27. Alan S, Tuna S, Türkoğlu E.B. The relation of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and mean platelet volume with the presence and severity of Behçet's syndrome. Kaohsiung J Med Sci 2015; 31: 626-31.
- 28. Ozcan Cetin E.H, Cetin MS., Canpolat U, et al. Platelet-to-lymphocyte ratio as a novel marker of in-hospital and long-term adverse outcomes among patients with acute pulmonary embolism: A single center large-scale study. Thrombosis Research 2017; 150: 33-40.
- 29. Ertem A.G, Yayla C, Acar B. Relation between lymphocyte to monocyte ratio and short-term mortality in patients with acute pulmonary embolism. Clin Resp J 2016; 27: 247-58.
- 30. Ateş H, Ates I, Kundi H, et al. Diagnostic validity of hematologic parameters in evaluation of massive pulmonary embolism. J Clin Lab Anal 2016 Oct 6. doi:10.1002/jcla.22072.
Ortalama platelet hacmi, platelet dağılım genişliği ve platelet/lenfosit oranının serebral venöz tromboz gelişimindeki rolü
Öz
Amaç: Ortalama platelet hacmi (OPH) ve platelet dağılım
genişliği (PDG), platelet hacmini gösteren parametrelerdir. Büyük plateletlerin
küçük plateletlere kıyasla enzimatik ve metabolik olarak daha aktif kabul
edilmektedir. Artmış OPH ve PDG değerleri ile arteryel tromboz arasındaki
ilişki gösterilmiştir ancak venöz trombozdaki yeri tam olarak bilinmemektedir.
İnflamatuar bir gösterge kabul edilen platelet/ lenfosit oranının
artışının(PLO) birçok hastalıkla ilişkisi bilinmekteyken venöz trombozda
kullanımı ile ilgili az sayıda çalışma mevcuttur. Bu nedenle bu çalışmamızdaki
amacımız OPH, PDG ve PLO değerleri ile serebral venöz sinüs trombozu(SVST)
arasındaki ilişkiyi ortaya koymaktır.
Yöntem: Çalışmamıza retrospektif olarak Ocak 2008- Eylül
2016 tarihleri arasında kliniğimizde SVST tanısı ile izlenmiş 54 hasta ile
benzer yaş ve cinsiyete sahip 50 kontrol dahil edildi. Hasta ve kontrol grubu
OPH, PDG ve PLO değerleri açısından kıyaslandı. Bunun yanında hasta grubu kendi
içinde beyin parankimal lezyonu olan ve olmayanlar olarak ikiye ayrılarak OPH,
PDG ve PLO’nun prognoz üzerindeki etkisi de değerlendirildi.
Bulgular: Hasta grubunda kontrollere kıyasla OPH, PDG ve PLO
değerleri daha yüksekken parankimal lezyonu olan ve olmayan hastalar arasında
anlamlı fark saptanmadı. Ek olarak SVST gelişimi için OPH ve PDG değerleri
anlamlı bağımsız değişkenler olarak saptanırken ROC analizi ile optimum cut-off
değerleri OPH için 8.85 iken, PDG için 15.75, PLO için ise 168.53 olarak tespit
edildi.
Sonuç: Sonuç olarak, OPH, PDG ve PLO değerleri SVST’li
hastalarda kontrollerden daha yüksek bulunmuştur ancak prognozu belirlemede
etkileri saptanmamıştır. Ek olarak, OPH ile PDG yüksekliğinin SVST gelişimi
için yeni bir bağımsız risk faktörleri olduğunu söyleyebiliriz.
Anahtar Kelimeler
Ortalama platelet hacmi platelet dağılım genişliği platelet/lenfosit oranı serebral venöz tromboz
Kaynakça
- 1. Masuhr F, Mehraein S, Einhaupl K. Cerebral venous and sinus thrombosis. J Neurol. 2004; 251: 11-23.
- 2. Zubkov AY, McBane RD, Brown RD, Rabinstein AA. Brain lesions in cerebral venous sinus thrombosis. Stroke. 2009; 40: 1509-11.
- 3. Lo´pez JA, Chen J. Pathophysiology of venous thrombosis. Thromb Res 2009;123(suppl 4):S30-S34.
- 4. Kuroiwa Y, Yamashita A, Miyati T, et al. MR signal change in venous thrombus relates organizing process and thrombolytic response in rabbit. Magn Reson Imaging 2011; 29: 975-84.
- 5. Puddu P, Muscari A, Puddu GM, Cravero E, Giannoni C, Zoli M. The complexity of platelet metabolism and its contribution to atherothrombosis. Acta Cardiol 2009; 64: 157-65.
- 6. Mayda-Domac¸ F, Misirli H, Yilmaz M. Prognostic role of mean platelet volume and platelet count in ischemic and hemorrhagic stroke. J Stroke Cerebrovasc Dis 2010; 19: 66-72.
- 7. Vizioli L, Muscari S, Muscari A. The relationship of mean platelet volume with the risk and prognosis of cardiovascular diseases. Int J Clin Pract 2009; 63: 1509-15.
- 8. Demirtunc R, Duman D, Basar M, Bilgi M, Teomete M, Garip T. The relationship between glycemic control and platelet activity in type 2 diabetes mellitus. J Diabetes Complications 2009; 23: 89-94.
- 9. Zuberi BF, Akhtar N, Afsar S. Comparison of mean platelet volume in patients with diabetes mellitus, impaired fasting glucose and nondiabetic subjects Singapore Med J 2008; 49: 114-6.
- 10. Jindal S, Gupta S, Gupta R, et al. Platelet indices in diabetes mellitus: indicators of diabetic microvascular complications. Hematology 2011; 16: 86-9.
- 11. De Luca G, Venegoni L, Iorio S, et al. Platelet distribution width and the extent of coronary artery disease: results from a large prospective study. Platelets 2010; 21: 508-14.
- 12. Kamisli O, Kamisli S, Kablan Y, et al. The Prognostic Value of an Increased Mean Platelet Volume and Platelet Distribution Width in the Early Phase of Cerebral Venous Sinus Thrombosis. Clinical and Applied Thrombosis/Hemostasis 2013; 19: 29-32.
- 13. Ntaios G, Gurer O, Faouzi M, Aubert C, Michel P. Hypertension is an indepedent predictor of mean platelet volume in patients with acute ischemic stroke [published online January 4, 2010]. Intern Med J 2010.
- 14. Chu SG, Becker RC, Berger PB, et al. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and metaanalysis. J Thromb Haemost. 2010; 8: 148-56.
- 15. Vagdatli E, Gounari E, Lazaridou E, Katsibourlia E, Tsikopoulou F, Labrianou I. Platelet distribution width: a simple, practical and specific marker of activation of coagulation. Hippokratia 2010; 14: 28-32.
- 16. Braekkan SK, Mathiesen EB, Njølstad I, Wilsgaard T, Størmer J, Hansen JB. Mean platelet volume is a risk factor for venous thromboembolism: the Tromsø Study, Tromsø, Norway. J Thromb Haemost 2010; 8: 157-62.
- 17. Gulcan M, Varol E, Etli M, Aksoy F, Kayan M. Mean platelet volume is increased in patients with deep vein thrombosis [published online November 22, 2011]. Clin Appl Thromb Hemost. 2011.
- 18. Cay N, Ipek A, Gumus M, Birkan Z, Ozmen E. Platelet activity indices in patients with deep vein thrombosis [published online September 23, 2011]. Clin Appl Thromb Hemost. 2011.
- 19. Simanek R, Vormittag R, Ay C, et al. High platelet count associated with venous thromboembolism in cancer patients: results from the Vienna Cancer and Thrombosis Study (CATS). J Thromb Haemost 2010; 8: 114-20.
- 20. Ishihara H, Kondo T, Yoshida K, et al. Effect of Systemic Inflammation on Survival in Patients With Metastatic Renal Cell Carcinoma Receiving Second-line Molecular-targeted Therapy. Clin Genitourin Cancer 2017 Feb 1. pii: S1558-7673(17)30034-4. doi:10.1016/j.clgc.2017.01.018. [Epub ahead of print]
- 21. Bin He C, Lin X.J. Inflammation scores predict the survival of patients with hepatocellular carcinoma who were treated with transarterial chemoembolization and recombinant human type-5 adenovirus H101. PLoS One 2017; 12: e0174769.
- 22. Liu H, Wu Y, Wang Z, Yao Y, Chen F, Zhang H, et al.. Pretreatment platelet-to-lymphocyte ratio (PLR) as a predictor of response to first-line platinum-based chemotherapy and prognosis for patients with non-small cell lung cancer. J Thorac Dis 2013; 5: 783-9.
- 23. Yang W, Liu Y. Platelet-lymphocyte ratio is a predictor of venous thromboembolism in cancer patients. Thromb Res 2015; 136: 212-5.
- 24. Ly HQ, Kirtane AJ, Murphy SA et al: Association of platelet counts on pre¬sentation and clinical outcomes in ST-elevation myocardial infarction (from the TIMI Trials). Am J Cardiol 2006; 98: 1-5.
- 25. Osadnik T, Wasilewski J, Lekston A, et al. The platelet-to-lymphocyte ratio as a predictor of all-cause mortality in patients with coronary artery disease undergoing elective percutaneous coronary intervention and stent implantation. J Saudi Heart Assoc 2015; 27: 144-51.
- 26. Gary T, Pichler M, Belaj K et al: Platelet-to-lymphocyte ratio: a novel marker for critical limb ischemia in peripheral arterial occlusive disease patients. PLoS One 2013; 8: 676-88.
- 27. Alan S, Tuna S, Türkoğlu E.B. The relation of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and mean platelet volume with the presence and severity of Behçet's syndrome. Kaohsiung J Med Sci 2015; 31: 626-31.
- 28. Ozcan Cetin E.H, Cetin MS., Canpolat U, et al. Platelet-to-lymphocyte ratio as a novel marker of in-hospital and long-term adverse outcomes among patients with acute pulmonary embolism: A single center large-scale study. Thrombosis Research 2017; 150: 33-40.
- 29. Ertem A.G, Yayla C, Acar B. Relation between lymphocyte to monocyte ratio and short-term mortality in patients with acute pulmonary embolism. Clin Resp J 2016; 27: 247-58.
- 30. Ateş H, Ates I, Kundi H, et al. Diagnostic validity of hematologic parameters in evaluation of massive pulmonary embolism. J Clin Lab Anal 2016 Oct 6. doi:10.1002/jcla.22072.
Ayrıntılar
| Konular | Sağlık Kurumları Yönetimi |
|---|---|
| Bölüm | Medical Science Research Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 18 Aralık 2017 |
| Kabul Tarihi | 27 Ekim 2017 |
| Yayımlandığı Sayı | Yıl 2017 |